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Surgical lesions of the small colon and post operative survival in a UK hospital population
Author(s) -
Bont M. P.,
Proudman C. J.,
Archer D. C.
Publication year - 2013
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12005
Subject(s) - medicine , exploratory laparotomy , lesion , laparotomy , surgery , population , survival analysis , proportional hazards model , abdominal pain , environmental health
Summary Reasons for performing study There is limited information about risk factors and survival associated with disorders of the small colon requiring surgical management. Objectives 1) To document the types of surgical lesion in horses where pathology of the small (descending) colon was the primary cause of abdominal pain, 2) to describe the short‐ and long‐term survival of these cases and identify factors associated with survival and 3) to identify preoperative variables associated with localisation of a lesion to the small colon. Methods Clinical data and long‐term follow‐up were obtained for horses that underwent exploratory laparotomy over a 10‐year period. Descriptive data were generated for short‐ and long‐term survival and survival analysis performed to identify factors associated with reduced survival. Univariable and multivariable relationships were explored using a C ox proportional hazards model. Preoperative factors associated with increased likelihood of a small colon lesion were explored, using controls randomly selected from horses undergoing exploratory laparotomy for treatment of colic unrelated to the small colon. Results The study population included 84 horses. Of horses with small colon lesions recovered from anaesthesia, the percentage that survived until discharge, one year and 2 years following surgery, was 91.0, 81.0 and 73.5%, respectively. Median survival time for horses in which a resection had been performed was 1029 vs. 3072 days in the nonresection group. Small colon cases were more likely to have shown a longer duration of colic signs prior to admission ( P <0.001) and to develop post operative diarrhoea ( P = 0.001) when compared with surgical controls. Conclusions Lesions of the small colon carry a good prognosis for survival following surgery. Resection and anastomosis was the only factor associated with reduced long‐term survival. Potential relevance This study provides information about lesion types and post operative survival that may be used to assist informed decision‐making when managing these cases.